healthcosts.net
Convert nephrostomy catheter at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,572.20
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
?
What you pay up front if you don't use insurance.
$4,287.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
?
The hospital's undiscounted list price — almost no one pays this.
$608.17 with Highmark BCBS of PA vs $3,643.95 with Humana — same scan, same building. Share
Negotiated rates by payer
?
Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
?
Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $608.17 | ↓ -76% |
| Aetna | Neighborhood Network | $1,080.32 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $1,153.84 | ↓ -55% |
| Aetna | Home Depot Employer Group | $1,174.64 | ↓ -54% |
| Aetna | NBR ASO/FI | $1,200.36 | ↓ -53% |
| Cigna | New Business ASO | $1,200.36 | ↓ -53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,354.09 | ↓ -47% |
| Aetna | EBR FI | $1,629.06 | ↓ -37% |
| UPMC Health Plan | Managed Medicare | $1,686.23 | ↓ -34% |
| Aetna | EBR ASO | $1,714.80 | ↓ -33% |
| Cigna | Commercial | $1,714.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,760.25 | ↓ -32% |
| Highmark BCBS of PA | Managed Care | $1,813.50 | ↓ -29% |
| Aetna of PA | Medicare | $2,050.66 | ↓ -20% |
| UPMC Health Plan | Commercial | $2,102.77 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,109.06 | ↓ -18% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,109.25 | ↓ -18% |
| Aetna | Medicare | $2,148.31 | ↓ -16% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,357.47 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $2,357.85 | ↓ -8% |
| Coventry/First Health | Commercial | $3,000.90 | ↑ +17% |
| Private Health Care Systems | PPO | $3,429.60 | ↑ +33% |
| SelectCare | Commercial | $3,429.60 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $3,627.00 | ↑ +41% |
| Humana | Commercial | $3,643.95 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Convert nephrostomy catheter at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $8,884.20 | $608.17 – $12,585.95 |
| UPMC Mercy | Pittsburgh | $1,941.60 | $602.44 – $2,912.40 |
| UPMC Presbyterian | Pittsburgh | $8,699.40 | $608.17 – $12,324.15 |
| UPMC Northwest | Seneca | $2,643.00 | $1,153.84 – $3,744.25 |
| UPMC Somerset | Somerset | $4,953.00 | $596.34 – $6,191.25 |
| UPMC Williamsport | Williamsport | $3,489.60 | $993.28 – $4,652.80 |